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Saudi Journal of Radiology

Volume 4, 2025 · Issue 1st Issue · Open Access · Double-blind Peer-review

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Original Research Article

The Outcome of Conservative Management and Endovascular Embolization for Spontaneous Intra-abdominal Hemorrhage: A Retrospective Study of Cases from 2016 to 2022

Abdulaziz AlTaweel1, Ahmad Joueidi2, Mustafa Owaidah2, Ahmad Siddiqi2, Faisal Joueidi2, Hirdah Tauqir Rana2, Suliman Alrajeh1, Tauqir Rana1 & Abdullah AlJohani3

1 King Faisal Speccialisy Hospital and Research Center, Riyadh, Saudi Arabia

2 Alfaisal University, Riyadh, Saudi Arabia

3 King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Published: 05 May 2026

https://doi.org/10.55038/3pqsmn70
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Abstract

Aim: This retrospective study aimed to evaluate the effectiveness of different management strategies for such patients and explore the clinical outcomes related to these treatments.

Methods: This was a retrospective study that included a total of 33 patients who presented with spontaneous intraabdominal hemorrhage at a tertiary care center. The patients’ demographics, clinical characteristics, laboratory findings, treatment modalities (conservative management, endovascular embolization), and outcomes were evaluated. Comparative statistical analyses were performed to assess the impact of treatment approaches on patient outcomes.

Results: The majority of patients were female (72.7%) and of Saudi nationality (72.7%). Warfarin (21.2%) and heparin (21.2%) were the most frequently prescribed anticoagulants. The study demonstrated a significant postoperative reduction in systolic blood pressure (p = 0.031), indicating the effectiveness of timely intervention. Furthermore, the conservative management approach showed significant preoperative and postoperative improvements in systolic blood pressure, hemoglobin levels, and platelet counts compared to endovascular embolization. Blood transfusion volumes were significantly lower in the conservative management group (p = 0.002). The presence of rebleeding postoperatively was borderline significant (p = 0.074), favoring patients undergoing endovascular embolization.

Conclusion: Effective management of spontaneous intraabdominal hemorrhage in anticoagulated and antiplatelet-treated patients is a multifaceted challenge.

KeywordsIntraabdominal HaemorrhageEndovascular EmbolizationAnticoagulant therapyConservative managementHemodynamic stabilityBlood transfusion

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